Challenging behaviour is symptomatic of a perceived lack of care,
be it real or imagined.
It can be exhibited by carers and patients
and ranges from verbal abuse
through to acts of physical violence.
To help reduce incidents of challenging behaviour,
SA Health has released
a comprehensive challenging behaviour strategy
focused on prevention and responding to individual events.
The strategy is a visible commitment
to the prevention of harm to consumers, workers
and other SA Health employees.
SA Health is committed to patient-centred care.
Indeed, Transforming Health has also articulated that commitment
to the people of South Australia.
So it is really, really good that we see as one of the new initiatives
the challenging behaviour strategy.
This strategy is around enabling practitioners, clinicians
and those who look after patients,
our most vulnerable patients in the health system,
really to be able to provide them
with the right, safe, patient-centred interventions.
So, what does the tool kit do? What does the strategy do?
Well, it provides healthcare professionals, clinicians,
with a very clear set of guidance
around how we actually recognise challenging behaviours,
how we assess it in a patient-centred way,
how we can actually intervene
in a way that is respectful of the patient.
And most importantly know what to do
whenever we feel that the patient is at risk
or that staff are at risk.
WOMAN: All healthcare professionals and our patients deserve respect.
And we all have the right to a safe environment.
The preventing and responding to challenging behaviour strategy
represents a clear commitment
to develop and implement effective measures
to address challenging behaviour, violence and aggression
across SA Health.
The strategy aims to build workforce skills and education
through staff training, planning care around prevention and control,
de-escalation strategies
and prioritising evidence-based consumer-centred care.
The e-learning course is a welcome initiative
that is designed to arm all health professionals
with up-to-date knowledge
on challenging aggressive and violent behaviour.
It also provides important support and assistance
for those who are exposed to challenging behaviour,
violence or aggression
and imposes consequences for those who do jeopardise safety.
MAN: The emergency department at the Royal Adelaide Hospital
is one of the two busiest emergency departments in the state.
It also has the important role
of being the state's major trauma receiving centre.
The department sees about 73,000 patients a year
which averages out at about 200 patients a day.
The patients we see do exhibit challenging behaviour
and we see challenging behaviour problems every day.
It sometimes may be one or two patients a day, sometimes several.
And we see the whole spectrum of challenging behaviour problems
from property damage such as smashing a door or a window
right through to potential or actual physical abuse of staff.
And it's a problem that the staff deal with every day
and they deal with it professionally and take it in their stride.
Despite this, it inevitably has a long-term impact.
And if it's not dealt with properly, the staff can burn out
and take the problems home with them.
This new initiative called Challenging Behaviours
is very welcome and is recommended to all staff
who have to deal with patients exhibiting challenging behaviour.
MAN: We have a mix of career staff and committed regional volunteers.
And on any given day, up to 275 SAAS vehicles are on the road,
attending up to 719 cases.
All healthcare settings
have the potential for challenging behaviour to occur,
but a number are rated high risk.
This includes SAAS.
SAS have to contend not only with needs of their patients
but also with members of the public,
who through anxiety, deliberate acts of belligerence or intoxication
can exhibit the most aggressive
and violent forms of challenging behaviour.
There's been a steady increase in the number of acts of violence
and aggression towards ambulance clinicians over the past few years.
Of most concern is the escalating trend of violence against our staff.
More frequently now, ambulance clinicians face being spat on,
aggressive behaviour, sometimes with weapons,
threats of violence right up to physical assault,
including kicks, bites and punches.
I am pleased that SA Ambulance Service have been identified
as a first priority for the public awareness campaign.
We're hoping to see a change in attitude
from some members of the community
to make them aware
that violent or aggressive behaviour towards us is unacceptable
and there are severe consequences.
The tagline of the campaign is
"I can't fight for your mate's life if I'm fighting for mine."
SA Health's Challenging Behaviour strategy
will add to the work we've already done in protecting our staff.
This strategy has brought...
In it's development it's brought together consumers, carers,
family members, clinicians and administrators
to really look at what's behind the issue of challenging behaviours.
Behaviours are actually a form of communication.
And when they're challenging,
there's real and significant reasons behind those behaviours.
Patient-centred care,
or consumer-centred care as we like to call it,
really should be central to how health services are designed,
delivered and evaluated.
With the strategy, the Challenging Behaviours strategy,
is an example of really putting patients and their carers,
their families, at the centre of a service response.
Involving consumers early on,
consumers and carers early on in this strategy development,
has meant that we've got a much stronger strategy.
We've got a strategy which recognises
the diversity of experience out there in the community.
I encourage all of our staff
to access the Challenging Behaviour e-learning course
and to have a read through the tool kit.
Together we can support actions
to prevent and then safely respond to challenging behaviour.